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Emergency medicine at the crossroads? The impact of NEAT on professional values

23 Jul 2014, by Informa Insights

Associate Professor April Wright from the University of Queensland Business School
Associate Professor April Wright from the University of Queensland Business School

Associate Professor April Wright from the University of Queensland Business School is investigating the impact of the ‘4-hour rule’ on Emergency Medicine in Queensland.

After investigating institutional change processes in English country cricket, April Wright turned her attention to the regulation of the health sector in 2009 firstly with an ARC Linkage Grant ‘Institutional logics in organisations: The interplay between managerial and professional logics in hospitals.

This study explored how conflicts in hospitals can reflect deep incompatibilities in professional logics, defined as a set of shared values, beliefs, and role identities which professionals use to evaluate problems, solutions, and the meaning of their work.

This research identified types of episodic problems that arose when referring emergency patients and the strategies available to doctors to resolve these problems. These strategies included making rhetorical appeals, drawing on social capital, and brokering inter-organisational commitment.

The project also provided three exemplar case studies that detailed processes of how bottom-up improvements in patient flow can be achieved in public hospitals. This included the development of new pathways for trauma and chest pain patients, and the clinical redesign of the hospital’s Fast Track unit. Lastly, the project provided policymakers with a baseline understanding of the day-to-day work of a large public hospital prior to the introduction of NEAT.

April now leads the ARC Disovery project research project ‘Environmental jolts and the professions: Multi-level institutional changes processes in Emergency Medicine in Australia. Her research team includes industry co-investigators Dr Victoria Brazil (Bond University & Gold Coast Hospital), Dr John Burke (Royal Brisbane) and Assoc. Professor Tony Brown (UQ & Royal Brisbane).

The new project investigates the impact of the implementation of NEAT, conceptualised as an ‘environmental jolt’ that has the potential to disrupt and change the care that emergency care professionals provide. The project will run for three years and involve data collection at a range of Emergency Departments in Queensland. The project’s focus is on how this jolt unfolds over time and across institutional, organisational, and individual levels and will provide important insights into multi-level change processes that can be catalysed by this type of regulatory change.

Both projects seek to inform healthcare sector management, government policy and public debate and improve work practices, staff orientation and training programmes in response to regulatory change.

For further information, please contact Associate Professor April Wright from the University of Queensland Business School on

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